Related Experiment Video

Updated: Jul 10, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Epidemiology of stroke after cardiac surgery in the current era

Ani C Anyanwu1, Farzan Filsoufi, Sacha P Salzberg

  • 1Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, NY, USA.

The Journal of Thoracic and Cardiovascular Surgery
|November 3, 2007
PubMed

Insights

Stroke incidence after diverse cardiac surgery is low at 2.6%. A logistic model identifies 10 preoperative predictors, aiding in patient selection and stroke prevention research.

Area of Science:

  • Cardiology
  • Neurosurgery
  • Public Health

Background:

  • Previous stroke epidemiology studies focused on coronary bypass surgery, limiting applicability to diverse contemporary cardiac surgery populations.
  • Understanding stroke risk in varied cardiac surgical procedures is crucial for modern patient care.

Purpose of the Study:

  • To examine the epidemiology of stroke in a contemporary, heterogeneous cardiac surgery population.
  • To identify preoperative predictors of stroke after cardiac surgery.
  • To develop a predictive model for stroke risk in cardiac surgery patients.

Main Methods:

  • Retrospective analysis of a prospective database of 5085 adult patients undergoing various cardiac surgeries between 1998-2004.
  • Analysis included coronary bypass, isolated valve, valve/coronary bypass, thoracic aorta, transplant/assist device, and adult congenital procedures.
  • Multivariate logistic regression identified preoperative stroke predictors.

Main Results:

  • Overall stroke incidence was 2.6% (134 patients), with variations by procedure (e.g., 1.7% for coronary bypass, 4.6% for ascending aorta).
  • Stroke patients had significantly higher perioperative mortality (32.8% vs 4.9%) and longer hospitalizations (30 vs 7 days).
  • Ten preoperative predictors were identified: gender, age, aortic surgery, prior stroke, critical state, poor ventricular function, diabetes, peripheral vascular disease, unstable angina, and pulmonary hypertension.

Conclusions:

  • A relatively low stroke incidence was observed in a diverse contemporary cardiac surgical cohort.
  • A developed logistic model can identify high-risk patients preoperatively.
  • The model aids in improving patient counseling, selection, and defining cohorts for stroke prevention research.
Abstract

Related Concept Videos

Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...